Abstract
Elderly patients with acute ST-elevation myocardial infarction (STEMI) remain undertreated. To evaluate the management of elderly STEMI patients treated in a formal regional network of care. This prospective analysis, based on data from the ongoing RESURCOR coronary emergency network, involved 6169 patients presenting with an acute STEMI between 2002 and 2011 in the north French Alps. Patients were divided into age groups: <65, 65-74, 75-84 and ≥85 years. Reperfusion rates, types, timing and adjunctive medications were compared. The RESURCOR network advocates primary percutaneous coronary intervention (PPCI) over fibrinolysis and bivalirudin over glycoprotein inhibitors (GPI) in the elderly. Lack of reperfusion therapy increased with age (Table). The rate of fibrinolysis was higher than that for PPCI in younger patients whereas the situation was reversed in elderly patients. In patients who had PPCI, use of bivalirudin increased and GPI decreased with age, system delays were similar. These regional French data indicate that elderly STEMI patients receive appropriate management with timely delivered PPCI and bivalirudin; however, a substantial proportion are still undertreated. Abstratct 0456 – Table: Reperfusion rates, types, timing and adjunctive medications among the age groups Age groups <65 years n=3476 65-74 years n=1238 75-84 years n=1147 ≥85 years n=308 P-value No reperfusion, n (%) 3.8 5.6 8.0 13.6 <0.001 Fibrinolysis, n (%) 1853 (53.3) 593 (47.9) 449 (39.2) 87 (28.3) <0.001 Primary PCI, n (%) 1492 (42.9) 576 (46.5) 606 (52.8) 179 (58.1) <0.001 Delay (first medical contact to PPCI), median (IQR), min 80 (58-123) 85 (60-125) 85 (64-130) 84 (60-124) 0.1 Bivalirudin * , n/N (%) 81/1197 (6.8) 30/429 (7.0) 48/373 (12.9) 28/121(23.1) <0.001 GPI * , n/N (%) 1375/2695 (51.0) 493/963 (51.2) 435/879 (49.5) 85/222 (38.3) 0.003 * Calculated among patients undergoing a coronarography. Bivalirudin has been used since 2008.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
